Keys to Prevention

If you are in a chair or wheelchair:

  • Talk to your nurse about getting a chair cushion to reduce pressure.
  • Remember that comfort and good posture are important.

Improve your ability to move:

  • Ask your nurse if you qualify for a rehabilitation program designed to help you improve movement.

Be Active in Your Care!

Reduce your risk of getting pressure ulcers. Get your family and health care team involved in pressure ulcer prevention.

If you or your loved one is receiving hospice and/or palliative care, it is important that you discuss the goals of care for pressure ulcer management and prevention with a health care provider. When turning and repositioning during end-of-life care, the goal should be comfort, thus the turning schedule should be made in consultation with you and/or your family.

  • Ask questions
  • Explain your needs, wants, and concerns
  • Understand what and why things are being done
  • Know what is best for you

The Pressure’s Off

Protect Your Skin From Pressure Ulcers

Facility Name here

What is a Pressure Ulcer?

A pressure ulcer, sometimes called a bedsore, is an injury to the skin and underlying tissue usually caused by constant pressure.

Pressure ulcers usually occur on the shoulders, elbows, hips, buttocks, and heels. These areas are found over bony parts of the body that sustain pressure when lying in bed or sitting for long periods of time. Pressure ulcers begin as reddened areas, and can damage skin and muscles if not treated promptly.
Pressure ulcers can lead to:

  • Pain (notify a member of the health team if you are experiencing pain);
  • Slower recovery; and
  • Possible complications such as infection.

What Causes a Pressure Ulcer?

Pressure ulcers occur by constant pressure on the skin, squeezing tiny blood vessels which supply the skin with nutrients and oxygen. When the skin is starved of nutrients and oxygen for too long, the tissue dies and a pressure ulcer forms.

Pressure ulcers can also be caused by sliding down in a bed or chair. This stretches or bends blood vessels, causing pressure ulcers. Even slight rubbing or friction on the skin may cause minor pressure ulcers that can quickly worsen.

Are You at Risk?

If you have any of the following conditions you may have an increased risk for pressure ulcers:

  • Inability to change positions
  • Continuous or periodic loss of bowel and/or bladder control
  • Poor nutrition and hydration
  • Lowered mental awareness
  • Other medical conditions such as Diabetes Mellitus

How to Prevent Pressure Ulcers?

Limit Pressure:

  • If you are in bed, your position should change at least every two hours.
  • If you are in a chair, your position should change at least every hour.
  • If you are able to shift your own weight, you should do so every 15 minutes while sitting.

Reduce Friction:

  • When shifting positions, or moving in bed, don’t pull or drag yourself across the sheets. Also, don’t push or pull with your heels.
  • Avoid repetitive movements like rubbing your foot on sheets to scratch an itchy spot.
  • Avoid the use of doughnut-shaped cushions – they can cause injury to deep tissues.

Safeguard Your Skin from Moisture:

  • Use absorbent pads while in bed and briefs while out of bed that pull moisture away from your body.
  • Apply cream or ointment to protect your skin from urine and/or stool.

Take Care of Your Skin:

  • Allow members of your health care team to inspect your skin at least once a day.
  • If you notice abnormal areas, notify your nurse as soon as possible.
  • Clean your skin thoroughly as soon as possible after soiling.
  • Prevent dry skin by using creams.
  • Don’t rub or massage skin over bony parts of your body.

If you are confined to bed for long periods of time:

  • Ask your nurse if you need a special mattress or overlay.
  • Try to keep the head of your bed as low as possible (unless other medical conditions do not permit it). If you need to raise the head of the bed for activities, try to raise it to the lowest point possible for a short period of time.
  • Pillows or foam wedges should be used to keep your knees or ankles from touching each other.
  • Avoid lying on your hip bone when lying on your side. A position that spreads weight and pressure
    more evenly should be chosen if possible - pillows may help.
  • If you cannot move at all, pillows should be placed under your legs from mid-calf to ankle to keep your heels off the bed. Never place pillows behind your knees.